Just In Time

By Dr.Ranvir Singh Saluja PRN: 09040141057 MBA-HHC(9-11) SIHS , PUNE

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Aim

Effective implementation of business processing outsourcing unit (BPO) for the purpose of scheduling appointments.

Objectives
To frame a proper procedure for the appointment system. Break and study all the steps involved in the procedure. Analyze and fill the gaps with adequate strategic fit. To increase the efficiency and effectiveness of the whole procedure.

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Introduction

This is a case study on P.D.Hinduja hospital , Mumbai. Its history is as follows : Mr. ParmanandHinduja pooled resources and set-up an outdoor clinic the 'Seth

DeepchandGangaramHinduja Health Care' in December 1951 in Dubash House, a rented building on Cadell Road (now Veer SavarkarMarg), to cater primarily, to the needs of the refugees. A few motivated doctors from the Sindhi community formed the core of the medical faculty. It had elementary outpatient facilities and its own dispensary. Just a year later, in February 1953,the 'National Hospital' came into being with 30 beds; the bed strength gradually went upto 70.

A few motivated doctors from the Sindhi community formed the core of the medical faculty. It had elementary outpatient facilities and its own dispensary. Just a year later, in February 1953,the 'National Hospital' came into being with 30 beds; the bed strength gradually went upto 70.

Unfortunately, ShriParmanandHinduja passed away in 1971 before concrete steps could be taken to implement his ideas. Thereafter his sons carried forward the legacy of their father, of translating his dream into a reality. In 1976 the society renamed the National Hospital as the "P.D.Hinduja National Hospital and Medical Research Centre" as a humble tribute to the Founder's pioneering efforts to bring modern health care within reach of the common man.

The family soon took steps to create a tertiary care hospital. The Hinduja brothers entered into a collaborative arrangement with the world-renowned Massachusetts General Hospital in Boston, the oldest and largest of the teaching hospitals associated with the Harvard Medical School for assistance in planning, equipping and staffing the new complex.

Detailed plans were formulated to construct a 16 storeyed building on the newly purchased plot
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and

it

was

also

decided

to

add

two

more

floors

to

the

east

building.

1986 was a landmark in the history of the Hinduja National Hospital. On August 16th, the dream was realized with the commissioning of the new 300-bed tertiary care hospital complex. The project funded by the family, had state-of-the-art equipment and was staffed by a team of brilliant doctors, many of them with foreign qualifications and experience.

The concept of full time consultants, which was new to Mumbai, was introduced against odds, while maintaining the pluralistic pattern of hospital-based, visiting and part-time consultants. The principle that all payments to consultants should be through the hospital was also laid down.

In 1991 a new plot of land close to the east building was purchased and two new buildings were constructed to accommodate the nursing school and provide residential quarters for doctors, nurses and nursing students thus making available additional space for medical activities in the east building.

Hinduja hospital has an OPD of

3 floors , popularly known as Old Building or

Hinduja Clinic. It basically has all the OPD facilities one can think of in the OPD including executive health checkups and various kind of scopies . On an average the number of OPD registrations are around 550 to 650 including both new registrations and follow up patients.

Each OPD floor has a telecom service where the customers just have to pick up the receiver of the black colored phone hanging on the wall and this will get him connected to the Hinduja BPO situated in Vashi, Navi Mumbai . The operator who picks up phone asks for theHinduja hospital number better known as HH Number. And he also asks for the name of the doctor for whom the appointment has to be made. Accordingly the operator looks at the schedule of that particular doctor and assigns a date and time to the customer and an appointment number is given to the customer.
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Assumption

Now the assumptions made over here by the customer are firstly: the time allotted to him is accurate and that he will get to meet the doctor exactly on time , secondly if there is any change in the schedule then the customer concerned would be told about it well in advance.

Findings:

It is noted that the assumptions stated above are completely theoretical , but in the practical scenario things notably differ.

The basic issue is every single day it was noted that at least 3 to 4 patients had the same problem saying that they had taken an appointment around 2 months back for a particular doctor and they had travelled a long way to keep up with the appointment timing , but the doctor on that particular day had not been able to make it on time due to certain reasons or had completely called it a day without any prior information to the authority concerned. This indicated (lack of adherence to time).

This has resulted into two major adverse effects: one that the reputation of the hospital has been hampered , secondly ill has been told by word of mouth which has an impact on the goodwill of the hospital and this has indirectly adversely affected the profit margins as patient would not come again for any type of treatment in this hospital.

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Methodology

Data was collected from 17th June to 2nd July 2010. By random sampling distribution , it was a primary data collection and for the same a self devised tool was made called appointment tracking sheet consisting of the following details:Appointment tracking sheet Name of the doctor:Appointment time :Appointment date:Appointment taken on:Waiting time:Service availed/ not availed:Reasons:-

Total samples collected = 63.

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Problems

Their was no accountability as the operator at the BPO was a person with a non medical background and it was not mandatory for him to give his name to the customer. Patients who were to take appointments on phone were lower middleclass and opted for free OPD ,so not much stress was given as far as quality is concerned. Patients were given wrong appointments e.g. patients who had asked for gastro logy were by mistake given appointment for rheumatology. If their was any change in the schedule , then the operator would call the patient just for the sake of it and would talk to any member of the family and would not take pains to have a direct word with the patient itself. The end result of the above has been frustration in the minds of the customer and the Hinduja hospital reputation is also hampered.

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Conclusion

The study conducted on this issue revealed that , the major reason for chaos as far as appointment is concerned is because of lack of a fixed protocol and the other major reason is lack of proper training of the BPO staff.

There was no tool designed to collect patient information neither any instructions were given to the patients to keep a track of the operator they had a word with in the BPO. As maximum patients are not from a well to do family , they are least bothered about re confirming the schedule and they take it for granted that everything would sail through as scheduled.

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Recommendations

Use strategic planning model to plan a perfect strategic fit after doing the gap analysis: Assessment-includes environmental scan ,background information ,situational analysis, SWOT analysis. Baseline-significant issue ,gaps. Components-mission ,vision ,values ,guidelines ,major goals. Down to specifics-performance measurements ,targets ,standard of performance ,action plans. Evaluate-performance management ,take corrective actions ,feedback. Business level strategy- not to completely outsource the BPO so that it can be monitored by the hospital administration.. Business level strategies includes:

i. introduction stage ii. growth stage iii. maturity stage iv. decline stage Training of BPO staff as to how to receive phone calls and regarding common hospital terms and operations. This is one of the critical success factor-. These are basically 12 important factors which decide the success of a business. A proper sheet containing all the information regarding the operator should be given to the customer , so that he may prove the operators accountability during adverse situation. It should be made compulsory for the operator to call the concerned customer (same person who had taken the appointment) in case of any change in the schedule.

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 Compensate the customer for the loss incurred in terms of time by providing value added services (tea on the house ,magazines etc)

-What is a strategy? It is a long term planning based on the objectives of the company. -Types of strategies? Corporate level strategy.-to outsource the appointment system. Business level strategy.-to have it monitored by hospital authorities. Functional level strategy.-keeping staff ,their training ,setting protocols etc

Tool- is a device used to collect adequate data ,which would guide the study to a particular result or inference.

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Bibliography

Google search. www.HINDUJAHOSPITAL.com Principles of Management and Strategic Management notes by Dr. A.Deshpande sir. www.wikipedia.com

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